| NPI | 1487853107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD15592) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301115461) |
| 207Q00000X Family Medicine (Licence: ME 018496) | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2020-10-29 |