| NPI | 1902899321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME142856) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 219921) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2023-01-12 |