| NPI | 1083066187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME137371) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN22893) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2019-11-10 |