| NPI | 1063900447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME177773) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101269303) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2026-08-18 |