| NPI | 1548446487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME83731) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME83731) |
| 207Q00000X Family Medicine (Licence: HI MD-15428) | |
| 208D00000X General Practice (Licence: HI MD-15428) | |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2010-08-31 |