| NPI | 1093797854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124549) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 043928) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2025-10-16 |