| NPI | 1558535559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD18621) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MA 232521) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2012-07-24 |