| NPI | 1083796635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 257311) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 048486) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2015-02-11 |