| NPI | 1205121175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 18940) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 257438) |
| Enumeration Date | 2011-06-18 |
| Last Update Date | 2026-01-02 |