| NPI | 1114995370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME131264) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 18282) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2021-06-08 |