| NPI | 1689807166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME137553) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0074942) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: PA mt196158) | |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2018-09-14 |