| NPI | 1801157185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME122011) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN#17328) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2015-08-25 |