| NPI | 1154618155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME161837) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 36241) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2023-11-08 |