| NPI | 1093161275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME138731) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 32240-R) |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2023-07-15 |