| NPI | 1669730057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 278109) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10042799) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2022-07-21 |