| NPI | 1982099669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME144579) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 51440) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2025-09-03 |