| NPI | 1982998522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 19363) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A12484) |
| 207Q00000X Family Medicine (Licence: ME LT16003) | |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2019-03-25 |