| NPI | 1144200569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME104172) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0045005) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2016-02-05 |