| NPI | 1386728079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042.0013167) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX G5641) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2024-12-02 |