| NPI | 1104118603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME140731) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A128977) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2024-05-09 |