| NPI | 1558551010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 261305) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 37300) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2021-09-23 |