| NPI | 1417516691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V3821) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL DO.2554) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2024-10-03 |