| NPI | 1932514494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME131046) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R3506) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2022-07-21 |