| NPI | 1093240897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2023039089) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S7167) |
| 207Q00000X Family Medicine (Licence: OK 36931) | |
| Enumeration Date | 2017-04-29 |
| Last Update Date | 2023-10-05 |