| NPI | 1508399601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-00130) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME140115) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2025-03-19 |