| NPI | 1083677793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2017-0489) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX H5566) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2022-07-21 |