| NPI | 1710482831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: FL ME142756) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN26696) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2020-09-02 |