| NPI | 1023279916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME115466) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 051025) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2021-12-08 |