| NPI | 1043299027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 209027) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101261551) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2023-09-13 |