| NPI | 1730126855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME116437) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO R8J56) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2014-04-18 |