| NPI | 1093823569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME101687) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 28064) |
| Enumeration Date | 2006-08-26 |
| Last Update Date | 2009-08-19 |