| NPI | 1750585253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D66271) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 13468) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2012-12-06 |