| NPI | 1245480268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 18587) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME125554) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2018-12-11 |