| NPI | 1063807543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A19078) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R1395) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2022-01-25 |