| NPI | 1699331157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME156670) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A180041) |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2024-12-30 |