| NPI | 1063899615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME129513) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 129513) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2022-06-05 |