| NPI | 1063634582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME96371) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME96371) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2018-11-08 |