| NPI | 1255728820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R6797) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10052600) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2023-03-13 |