| NPI | 1154625184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME69174) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME69174) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2011-06-23 |