| NPI | 1508496340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL APRN11010952) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN APN0000026459) |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2023-02-09 |