| NPI | 1225307796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME85315) |
| Additional Taxonomies | 208D00000X General Practice (Licence: DC MD31136) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2011-12-29 |