| NPI | 1093963407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 257550) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 26505) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2017-04-04 |