| NPI | 1457377244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME143191) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 41442) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2019-11-20 |