| NPI | 1205055969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME DO2397) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 241877) |
| 207Q00000X Family Medicine (Licence: WA OL20000106) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2018-01-15 |