| NPI | 1174020754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61447732) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T0416) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2023-09-29 |