| NPI | 1275716573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME109722) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO 2007032916) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2022-04-18 |