| NPI | 1043701220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME155592) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 238615) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2022-10-27 |