| NPI | 1942615851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME160271) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 68321) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2023-06-19 |