| NPI | 1508353962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME151712) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 100028389) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2021-09-14 |