| NPI | 1124555255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S7103) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO TL0006822) |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2021-02-01 |