| NPI | 1184616351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 46379) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME115978) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2015-02-18 |