| NPI | 1083973689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME142459) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 70474) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2023-02-16 |