| NPI | 1154722460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 21574) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME14814) |
| Enumeration Date | 2014-09-07 |
| Last Update Date | 2019-10-19 |