| NPI | 1114972312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME139379) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01045564A) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-09-16 |