| NPI | 1972189504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME169474) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 61461182) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2024-10-16 |