| NPI | 1649629445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 11772435-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1546) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2021-02-03 |