| NPI | 1639554272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 14164619-1205) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 29912) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2024-09-30 |