| NPI | 1114555620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-47913) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T4195) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2023-06-27 |