| NPI | 1659877371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-03469) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME152026) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2025-08-07 |