| NPI | 1235511452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME150026) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 295662) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2021-12-14 |