| NPI | 1669812376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V1761) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 7058) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2024-08-15 |