| NPI | 1275929499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S1533) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 293580) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2023-10-10 |