| NPI | 1053690388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q2872) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT198553) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2022-06-03 |