| NPI | 1023500303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME142014) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AZ 72734) |
| 208D00000X General Practice (Licence: NY 341136) | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2026-03-26 |