| NPI | 1649224114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 65631) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME136892) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2025-04-15 |