| NPI | 1831623214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 285032) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL40692) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2020-12-22 |