| NPI | 1679607592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME147554) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 66015) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2021-03-25 |