NPI | 1134611742 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME155979) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 286831) |
Enumeration Date | 2018-05-31 |
Last Update Date | 2024-04-08 |