| NPI | 1376670646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 047731) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 229642) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2017-04-07 |