| NPI | 1528410107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA R10741) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME166353) |
| 207Q00000X Family Medicine (Licence: FL TPME4132) | |
| 207Q00000X Family Medicine (Licence: TX U3123) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2026-03-19 |