| NPI | 1063709012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME114797) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TR16561) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2018-10-11 |