| NPI | 1659786135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CT 67335) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MA 270420) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2021-08-10 |