| NPI | 1831112200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 12466) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 209792) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2022-08-23 |