| NPI | 1770717126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME135880) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD445067) |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2026-04-23 |