| NPI | 1245632827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME132816) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L.4026R) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2025-09-12 |