| NPI | 1154815751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME152898) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11112) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2022-11-14 |