| NPI | 1568955912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-00145) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME150698) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2022-06-29 |