| NPI | 1477762839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME135256) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 15998) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2024-06-11 |