| NPI | 1558741686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME136536) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 000000000000) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2019-09-26 |