| NPI | 1245461177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4033) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 43613) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2022-07-21 |