| NPI | 1699938159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-02281) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N7875) |
| 207Q00000X Family Medicine (Licence: SC LL31130) | |
| Enumeration Date | 2008-07-04 |
| Last Update Date | 2022-12-07 |