| NPI | 1558397950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME169579) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L9079) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2024-12-16 |