| NPI | 1205277423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME126830) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-09875) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2018-09-28 |