| NPI | 1255629465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S8231) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 48843) |
| 207Q00000X Family Medicine (Licence: NC 2014-01424) | |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2021-04-21 |