| NPI | 1225324726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME134401) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116024013) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2018-08-24 |