| NPI | 1649705054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME DO3132) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME LT20078) |
| Enumeration Date | 2017-04-23 |
| Last Update Date | 2020-11-13 |