| NPI | 1093073454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME136388) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 27872) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2021-11-09 |