| NPI | 1336434430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 278526) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 8P10040877) |
| 207Q00000X Family Medicine (Licence: TX P9902) | |
| 207Q00000X Family Medicine (Licence: IA 41406) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2021-04-01 |