| NPI | 1588977375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 249387) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A109474) |
| 207Q00000X Family Medicine (Licence: NH 30989) | |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2025-10-08 |