| NPI | 1194988311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 005671) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME T0831) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2011-08-15 |