| NPI | 1689672867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME65520) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME65520) |
| 208D00000X General Practice (Licence: FL ME65520) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2021-08-17 |