| NPI | 1487918389 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME125201) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2012019694) | 
| Enumeration Date | 2012-06-26 | 
| Last Update Date | 2023-08-14 |