| NPI | 1104903277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124163) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 18570) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-09-14 |