| NPI | 1770756587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME123627) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2011024868) |
| Enumeration Date | 2008-04-12 |
| Last Update Date | 2020-06-26 |