| NPI | 1467983320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61509047) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S0077) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2024-04-01 |