| NPI | 1669739009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R8284) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 57345) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2022-03-01 |