| NPI | 1467659292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME106014) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE TEP 5610) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2022-03-28 |