| NPI | 1073694923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME95224) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 284439) |
| 207Q00000X Family Medicine (Licence: NH 22920) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2022-09-23 |