| NPI | 1871852038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 054458) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 264828) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2021-06-22 |