| NPI | 1013478262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 290340) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D95399) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2026-05-12 |