| NPI | 1164868204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX s3331) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10047347) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2022-05-24 |