| NPI | 1477503605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q2932) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD07597) |
| 207Q00000X Family Medicine (Licence: FL ME103009) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2026-02-25 |