| NPI | 1346773264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 60674) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME141699) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2020-09-30 |