| NPI | 1730381732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME99069) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL TRN8251) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2021-05-20 |