| NPI | 1659710044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9102) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT203859) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2024-05-07 |