| NPI | 1831392109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME100222) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME100222) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2011-11-24 |