| NPI | 1578725271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME108975) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN 12884) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2012-04-20 |