| NPI | 1407380892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME145439) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 228135) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2021-01-16 |