| NPI | 1558692145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME122080) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 64777) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2020-08-26 |