| NPI | 1699746909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD22056) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2002002037) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2019-12-02 |