| NPI | 1700814670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME153911) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 197521) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2022-02-09 |