| NPI | 1053372193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N0242) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD424952) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2022-01-27 |