| NPI | 1073277042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME CNP211332) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA RN2276310) |
| 207Q00000X Family Medicine (Licence: CO C-RXN.0001560-C-NP) | |
| 207Q00000X Family Medicine (Licence: NH 059776-23) | |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2022-05-25 |