| NPI | 1487965265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124959) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL32897) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2019-01-02 |