| NPI | 1104238971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 296698) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R4204) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2023-06-30 |