| NPI | 1457769267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 290759) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME EC141094) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2019-05-23 |