| NPI | 1063577690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME 117882) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD28371) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2017-03-28 |