| NPI | 1679034714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME151515) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T5590) |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2026-03-16 |