| NPI | 1376505636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME94476) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME 94476) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2011-11-21 |