| NPI | 1386939122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX S6687) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME120049) |
| 208D00000X General Practice (Licence: TX 45058) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2021-06-21 |