| NPI | 1497040844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 261028) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 16707) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2017-07-26 |