| NPI | 1821448846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA T286698) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101266724) |
| 207Q00000X Family Medicine (Licence: VA 0116029483) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2021-02-04 |