| NPI | 1871682559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME133149) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 23921) |
| 207Q00000X Family Medicine (Licence: VA 0101241296) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-10-28 |