| NPI | 1669975439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX s6268) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX S6268) |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2023-06-06 |