| NPI | 1568851681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T9747) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 281632) |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2023-01-12 |