| NPI | 1073246849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME172100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 9482) |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2025-09-08 |