| NPI | 1902966401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 15312) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 150066) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2017-03-30 |