| NPI | 1376759423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 22121) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 229053) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2022-12-22 |