| NPI | 1194285619 |
|---|---|
| Former Name | GABRIELLA MONIQUE SHAKUR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME152500) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME152500) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2023-12-08 |