| NPI | 1043662323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX BP1005582) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 299957) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2019-10-11 |