| NPI | 1922242163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 21756) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME MD19394) |
| 207Q00000X Family Medicine (Licence: WA 60830957) | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2021-09-09 |