| NPI | 1316442130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-46702) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S6826) |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2022-08-23 |