| NPI | 1336107531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M3312) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 41163 Temporary) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2023-11-08 |