| NPI | 1902989015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME 2134) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME T0644) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2009-09-04 |