| NPI | 1356684864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q4649) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10045834) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2021-01-07 |