| NPI | 1699200469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA ML60754607) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U1037) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2023-09-07 |