| NPI | 1043716145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA RN256510) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95008605) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2025-03-03 |