| NPI | 1295935047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME103390) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 0-661-376-4) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2024-08-19 |