| NPI | 1700146586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9272) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 29154) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2020-09-02 |