| NPI | 1376844514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME145879) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 18070) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2024-07-03 |