| NPI | 1033597125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S8880) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 56577) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2024-05-01 |