| NPI | 1649608845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME136264) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD045040L) |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2024-10-16 |