| NPI | 1144080151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX 1155162) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11031644) |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2024-03-19 |