| NPI | 1417453903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T3690) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1417453903) |
| 207Q00000X Family Medicine (Licence: TX 122016) | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2021-10-04 |