| NPI | 1669935417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME163353) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 316530) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2023-08-15 |