| NPI | 1255580528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N3190) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 249400) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2024-05-16 |