| NPI | 1760619928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME142270) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 241629) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2021-05-14 |