| NPI | 1457734600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO04946) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S6394) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2022-07-25 |