| NPI | 1942672050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME136428) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN22415) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2023-01-04 |