| NPI | 1639116593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME42310) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 42310) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2014-12-19 |