| NPI | 1346209665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 260794) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2026-00079) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2026-01-20 |