| NPI | 1952372807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME138729) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 13168) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-05-30 |