| NPI | 1689824781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P2612) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301090763) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2023-07-27 |