| NPI | 1043570450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P7779) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 59150) |
| 207Q00000X Family Medicine (Licence: NC 2023-02580) | |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2023-08-25 |