| NPI | 1245890680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U3036) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 280999) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2023-07-12 |