| NPI | 1770004616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME154250) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125071491) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2022-07-29 |