| NPI | 1699813378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P3179) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0433607) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2023-10-03 |