| NPI | 1275013237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S5383) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO5336) |
| 207Q00000X Family Medicine (Licence: FL OS15796) | |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2022-06-27 |