| NPI | 1841855525 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 290867)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 187166)  | 
| Enumeration Date | 2019-05-07 | 
| Last Update Date | 2023-08-17 |