| NPI | 1679997282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q2305) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 271944) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2023-12-28 |