| NPI | 1265812630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX u0009) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 26767) |
| 207Q00000X Family Medicine (Licence: CO TL.0005725) | |
| 207Q00000X Family Medicine (Licence: TN 3491) | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2023-01-17 |