| NPI | 1205396405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T3236) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 39897) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2023-11-13 |