| NPI | 1609288208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R4155) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301105562) |
| Enumeration Date | 2014-05-30 |
| Last Update Date | 2023-11-29 |