| NPI | 1558653790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL DO.2973) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX p8862) |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2022-08-31 |