| NPI | 1679700256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 277060) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 59875) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2018-12-04 |