| NPI | 1053724997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME132319) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 31022R) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2021-07-29 |