| NPI | 1871905018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 63797) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 271687) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2019-07-09 |