| NPI | 1285041129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R9312) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA MD-43675) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2021-08-17 |