| NPI | 1699209296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 40881) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME159085) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2023-04-27 |