| NPI | 1417390212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME144337) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.127696) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2022-03-25 |