| NPI | 1770576209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME176896) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 1770576209) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2026-02-17 |