| NPI | 1598964298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 27618) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 82904) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2010-09-30 |