| NPI | 1669112934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042.0018576) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME EC221008) |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2025-07-30 |