| NPI | 1073703773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T1833) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 260968) |
| Enumeration Date | 2007-07-29 |
| Last Update Date | 2021-09-13 |