| NPI | 1700527942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME169360) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN35316) |
| Enumeration Date | 2022-04-03 |
| Last Update Date | 2024-08-08 |