| NPI | 1558621193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2015-00956) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q2865) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2021-11-12 |