| NPI | 1538553003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 90780) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME133749) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2025-07-24 |