| NPI | 1518057439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N4662) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301086588) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2024-02-22 |