| NPI | 1316120900 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P0710) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT190718) | 
| Enumeration Date | 2007-12-06 | 
| Last Update Date | 2024-09-13 |