| NPI | 1376746677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME110139) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101-241109) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2023-11-21 |