| NPI | 1477849073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME DO2457) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2026-01751) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2026-05-19 |