| NPI | 1811334170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 266622) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT203951) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2020-09-16 |