| NPI | 1437644853 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: TX T2496) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10063872) | 
| Enumeration Date | 2018-06-27 | 
| Last Update Date | 2021-09-13 |