| NPI | 1548392293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S1764) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 33359) |
| 207Q00000X Family Medicine (Licence: IL 036-112594) | |
| 207R00000X Internal Medicine (Licence: IL 036-112594) | |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-09-22 |