| NPI | 1245467158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 31910) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 068278) |
| 207Q00000X Family Medicine (Licence: FL ME124437) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2021-10-08 |