| NPI | 1609205954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME152556) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 264256) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2023-12-22 |