| NPI | 1710340195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 51638) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME156939) |
| 207Q00000X Family Medicine (Licence: CA A158074) | |
| 207Q00000X Family Medicine (Licence: PA MD490461) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2025-07-28 |