| NPI | 1538253539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 13267) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME MD18280) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-10-01 |