| NPI | 1053833806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 21748) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME TP17052) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2021-08-16 |