| NPI | 1598177826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 303111) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q6762) |
| 207Q00000X Family Medicine (Licence: TX BP10050109) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2021-07-22 |