| NPI | 1376030015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T9979) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 317996) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2023-08-21 |