| NPI | 1932490240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME125505) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2015-0221) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2024-01-16 |