| NPI | 1649250606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME144522) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 23432) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2020-09-03 |