| NPI | 1457980062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U5335) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT219751) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2024-09-12 |