| NPI | 1801415716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X (Licence: ME MD28918) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT221618) |
| 2085R0001X (Licence: NH 34704) | |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2025-06-23 |