| NPI | 1225444995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OT015614) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME DO2713) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2022-07-21 |