| NPI | 1528183241 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME95942) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME95942) | 
| 174400000X Specialist (Licence: FL ME95942) | |
| Enumeration Date | 2007-03-20 | 
| Last Update Date | 2024-08-15 |