| NPI | 1073796637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME126690) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL A1007211) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2016-12-14 |