| NPI | 1558984369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME170134) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-10269) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2025-04-14 |