| NPI | 1033566443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 39943) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 103673) |
| 207Q00000X Family Medicine (Licence: ME MD26641) | |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2026-07-23 |