| NPI | 1801994561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD19336) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 6616A) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2014-12-01 |