| NPI | 1043690894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME129374) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN 21895) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2023-03-31 |