| NPI | 1861788085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME 118129) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN 16281) |
| 207Q00000X Family Medicine (Licence: FL ME118129) | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2019-03-06 |