| NPI | 1316027782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME101097) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN9292) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2011-12-29 |