| NPI | 1720374051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q2869) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61253482) |
| 207Q00000X Family Medicine (Licence: TX BP10040029) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2022-07-01 |