| NPI | 1750395109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME148164) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE TEP5319) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2021-03-25 |