| NPI | 1730601568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 21635) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME146553) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2022-12-13 |