| NPI | 1386671063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124584) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 23082) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2022-03-30 |