| NPI | 1720130305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N0422) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD069021L) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2024-02-20 |