| NPI | 1174819445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 17977) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME MD19936) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2021-09-20 |