| NPI | 1023150794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 41858) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J4510) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2023-01-11 |