| NPI | 1710143490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 6327) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 009821) |
| 207Q00000X Family Medicine (Licence: TX Q4083) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2023-11-28 |