| NPI | 1053779173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME132368) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 31919) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2022-07-21 |