| NPI | 1972952406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME139912) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 39626) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2019-07-18 |