| NPI | 1558566653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0113753) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL29760) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2021-03-24 |