| NPI | 1619089679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD161618) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD20050308) |
| 207Q00000X Family Medicine (Licence: FL ME91522) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-11-21 |