| NPI | 1710046206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX J2400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 54566) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2023-03-07 |