| NPI | 1609443985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME165596) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-12134) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2024-08-01 |