| NPI | 1588810956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME166529) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 29582) |
| Enumeration Date | 2008-08-17 |
| Last Update Date | 2024-05-03 |