| NPI | 1639238769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L0454) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS8021) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2023-02-03 |