| NPI | 1386915627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME162422) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 14302) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2024-04-10 |