NPI | 1396032389 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ME134860) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 247688) |
208D00000X General Practice (Licence: PR 020163) | |
Enumeration Date | 2011-06-29 |
Last Update Date | 2019-04-04 |