| NPI | 1972739597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME163425) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 31765) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2023-10-04 |