| NPI | 1528387743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME111754) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN15081) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2013-09-30 |