| NPI | 1619317997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9630) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 2882) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2021-04-29 |