| NPI | 1215336821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME133786) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA MD-44619) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2019-12-02 |