| NPI | 1578147435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX BP10074705) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX V0101) |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2024-05-13 |