| NPI | 1497712947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MA ME159413) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME89379) |
| 207Q00000X Family Medicine (Licence: MA 238552) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2023-01-20 |