| NPI | 1518220664 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME119333)  | 
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: FL ME119333)  | 
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME119333)  | |
| Enumeration Date | 2012-06-22 | 
| Last Update Date | 2022-09-02 |