| NPI | 1851590350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME122518) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 046511) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2016-02-08 |