| NPI | 1750720082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME DO2655) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 255973) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2019-03-11 |