| NPI | 1790906154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME105873) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 105873) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2019-06-06 |