| NPI | 1316668734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX J0946) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO R6780) |
| Enumeration Date | 2022-09-05 |
| Last Update Date | 2022-09-05 |