| NPI | 1639344500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 242586) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MA 232543) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2012-02-09 |