| NPI | 1760568935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME113555) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 41163) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2024-06-04 |