| NPI | 1457771628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S7288) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 75052) |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2021-10-19 |