| NPI | 1124580675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME157079) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11887171-1205) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2022-07-07 |