| NPI | 1982965620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2018-03023) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME MD20695) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2018-12-28 |