| NPI | 1750432209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME169455) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 55531) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2025-02-25 |