| NPI | 1114339611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD22719) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101263608) |
| 207Q00000X Family Medicine (Licence: VA 0101263608) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2024-07-27 |