NPI | 1265595524 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ME99422) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 190386) |
Enumeration Date | 2006-12-18 |
Last Update Date | 2016-02-04 |