| NPI | 1508029141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME107523) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57014024) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2021-11-09 |