| NPI | 1194087163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D74830) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME11158) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2019-05-28 |