| NPI | 1386802692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME144361) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.119879) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2023-09-29 |