| NPI | 1871097543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME152288) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T3173) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2022-08-05 |