| NPI | 1568801876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9261) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT203864) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2024-05-30 |