| NPI | 1407385966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VI 3353) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME143915) |
| 207Q00000X Family Medicine (Licence: PA MT213882) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-09-08 |