| NPI | 1477930717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R7299) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT016711) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2021-05-03 |