| NPI | 1508136227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P6183) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO2165) |
| 207Q00000X Family Medicine (Licence: FL OS11632) | |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2023-03-07 |