| NPI | 1275092660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 1022089) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 23090) |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2026-01-29 |