| NPI | 1336300664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 21080) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME 018705) |
| 207Q00000X Family Medicine (Licence: ME MD18705) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2015-11-03 |