| NPI | 1669765327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 8824045-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 49268) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2021-11-18 |