| NPI | 1861459117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME126749) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 22347) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2016-12-13 |