| NPI | 1700041506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C153088) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 1.053789) |
| 207Q00000X Family Medicine (Licence: NY 262234) | |
| 207Q00000X Family Medicine (Licence: MA 259023) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2019-05-17 |