| NPI | 1023233129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2024-1064) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME117255) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2025-03-04 |