| NPI | 1871993436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME129781) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D82379) |
| Enumeration Date | 2014-09-01 |
| Last Update Date | 2021-08-05 |