| NPI | 1154904712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME DO3457) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101028269) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2024-08-29 |