| NPI | 1679984561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME133609) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME133609) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2021-04-21 |