| NPI | 1700205069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME136037) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101261178) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-09-30 |