| NPI | 1720106438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P6728) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME93788) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2021-02-11 |