| NPI | 1609256924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T0926) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 60841477) |
| 207Q00000X Family Medicine (Licence: UT 9832805-8905) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2024-05-01 |