| NPI | 1205007036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME103566) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2023-09-28 |