| NPI | 1821411745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME125615) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME125615) |
| 208D00000X General Practice (Licence: FL ME125615) | |
| Enumeration Date | 2014-01-29 |
| Last Update Date | 2021-08-19 |