| NPI | 1235622960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U8086) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 290091) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-06-05 |