| NPI | 1285691055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME107583) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 036795) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2023-03-07 |