| NPI | 1679133177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T9715) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD478402) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2023-05-21 |