| NPI | 1376862987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME114969) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 067653) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2022-08-04 |