| NPI | 1588074157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60572152) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX V5713) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2025-02-03 |