| NPI | 1700378148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY C1119) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T2231) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2022-11-08 |