| NPI | 1184601106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R9156) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 41747) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2022-12-07 |