| NPI | 1104320514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T3843) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC MD049291) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2022-12-29 |