| NPI | 1598995359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R1080) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT195017) |
| 207Q00000X Family Medicine (Licence: TN 49645) | |
| 207Q00000X Family Medicine (Licence: MO 2013027473) | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2021-06-02 |