| NPI | 1649533795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 265052) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA ot014694) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2015-09-16 |