| NPI | 1679566277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME130360) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 15667) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2021-12-14 |