| NPI | 1598864217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 046455) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME 017640) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-10-17 |