| NPI | 1104374842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME144049) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 14,149-I) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2021-10-26 |