| NPI | 1679268767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME182370) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 90245) |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2026-06-25 |