| NPI | 1427443449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 109172911204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2015017165) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2023-06-27 |