| NPI | 1679247787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX 1049199) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 856810) |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2021-08-04 |