| NPI | 1275844995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H87146) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME T1074) |
| 207Q00000X Family Medicine (Licence: WV 2823) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2019-05-28 |