| NPI | 1053453878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME47118) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME0047118) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2023-01-30 |