| NPI | 1124387055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 262783) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2014-0638) |
| Enumeration Date | 2012-05-12 |
| Last Update Date | 2023-07-24 |