| NPI | 1730183443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-1889) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L-0503) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2020-12-08 |