| NPI | 1659980266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME166827) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS T-4303) |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2025-02-07 |