| NPI | 1215228267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME176797) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q9894) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2026-06-08 |