| NPI | 1306952197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD20831) |
| Additional Taxonomies | 208D00000X General Practice (Licence: ME MD20831) |
| 207Q00000X Family Medicine (Licence: MN 30451) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2025-08-12 |