| NPI | 1417969965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME111246) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 042571) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2022-08-22 |