| NPI | 1740222439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101276754) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME MD14020) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2023-10-23 |