| NPI | 1760851620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 265193) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ZZ 106330) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2016-01-11 |