| NPI | 1790014942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME112559) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L.3075R) |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2017-01-04 |