| NPI | 1518162130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M5717) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A9463) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2023-04-17 |