| NPI | 1417929688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2024-1018) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME93255) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2025-01-21 |