| NPI | 1255837498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME164738) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 70135) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2024-11-13 |