| NPI | 1588850549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 36808) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 237927) |
| Enumeration Date | 2007-09-23 |
| Last Update Date | 2022-10-20 |