| NPI | 1336222009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME 013971) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0053358) |
| 207Q00000X Family Medicine (Licence: SC 35859) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2014-03-14 |