| NPI | 1154550663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME162371) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 054160) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2023-12-21 |