| NPI | 1396999447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME122274) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OH 35120650) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2025-06-13 |