| NPI | 1790952026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 38696) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME109474) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2026-02-20 |