| NPI | 1134235617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124578) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 35336) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2021-03-24 |