| NPI | 1114941804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K2721) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 3248) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-01-05 |