| NPI | 1306952197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD20831) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 30451) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2016-02-05 |