| NPI | 1649584715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME126989) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 17962) |
| Enumeration Date | 2010-08-01 |
| Last Update Date | 2026-02-13 |