| NPI | 1760742803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME127768) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 005435) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2022-01-18 |