| NPI | 1245511500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: FL ME117013) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME117013) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2014-11-25 |