| NPI | 1124722467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A210244) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP06041) |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2026-07-09 |