| NPI | 1740273085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 22666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 049042) |
| 207Q00000X Family Medicine (Licence: FL ME113465) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2014-06-13 |