| NPI | 1447214572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME100289) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35-07-5557C) |
| 208D00000X General Practice (Licence: FL ME100289) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2019-03-20 |