| NPI | 1700141850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 28278) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE TEP6755) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2015-08-05 |