| NPI | 1659785830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R2618) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL36697) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2023-10-03 |