| NPI | 1528047693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4636) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 36103609) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2022-07-21 |