| NPI | 1235103441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME60296) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 222555) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2018-12-12 |