| NPI | 1558824011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 99224) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U2762) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2024-08-22 |