| NPI | 1619297744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 68690) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P7014) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2023-09-28 |