| NPI | 1558865550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U1149) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 287613) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2023-02-16 |