| NPI | 1174936223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME131562) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116027077) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2023-06-09 |