| NPI | 1508816950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME126489) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L9177) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2025-07-10 |