| NPI | 1609360841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME151572) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125072513) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2024-08-27 |