| NPI | 1598321390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 35.144101) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.144101) |
| 208D00000X General Practice (Licence: FL ME159761) | |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2025-10-31 |