| NPI | 1902837883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME137311) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.143023) |
| 207Q00000X Family Medicine (Licence: CO 43086) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-04-08 |