| NPI | 1770804148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME120265) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT197842) |
| Enumeration Date | 2010-06-19 |
| Last Update Date | 2020-05-20 |