| NPI | 1912938549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME94066) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 6893) |
| 207Q00000X Family Medicine (Licence: NM MD20050625) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2023-07-20 |