| NPI | 1770003477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 282866) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH RT-3139) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2020-12-17 |