| NPI | 1639603723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 7026) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10059389) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2023-02-06 |