| NPI | 1801926001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME139523) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 33166) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2021-08-13 |