| NPI | 1093129793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME137485) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R74539) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2021-12-17 |