| NPI | 1659464931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME69062) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 0069062) |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2019-04-11 |