| NPI | 1104895333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME26359) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 31500) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2022-10-13 |