| NPI | 1780875252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD19435) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 249191) |
| 207Q00000X Family Medicine (Licence: NH 14456) | |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2014-04-18 |