| NPI | 1003349648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 320516) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S1536) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2021-10-25 |