| NPI | 1851711329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 11461306) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 270617) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2021-05-04 |