| NPI | 1902467954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MA 291855) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH RT-3463) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2025-03-03 |