| NPI | 1457571408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME135090) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2009-00415) |
| 207Q00000X Family Medicine (Licence: VA 0101258088) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2018-06-12 |