| NPI | 1467766006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2021-01237) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME125197) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2023-08-23 |