| NPI | 1467682351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME153665) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 40429) |
| Enumeration Date | 2009-07-26 |
| Last Update Date | 2022-07-18 |