| NPI | 1225017403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R9542) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 24443) |
| 207Q00000X Family Medicine (Licence: IA IA35442) | |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2023-11-14 |