| NPI | 1356498695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME27590) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME0027590) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2011-10-19 |