| NPI | 1164916615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME173164) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21065) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2026-01-06 |