| NPI | 1376906230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME147715) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 218127) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2020-11-04 |