| NPI | 1699072256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME107104) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME107104) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2018-03-17 |