| NPI | 1225203755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 247420) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT 192134) |
| 207Q00000X Family Medicine (Licence: ME EC091017) | |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2014-05-27 |