| NPI | 1992048656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME140563) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 283079) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2022-01-30 |