| NPI | 1770563058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 12392) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 213702) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2024-07-12 |