| NPI | 1013533645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME162209) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2020017458) |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2023-09-11 |