| NPI | 1063893618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R5243) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 31741) |
| 207Q00000X Family Medicine (Licence: TX bp10051979) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2022-12-12 |