| NPI | 1730470147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P9257) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 49058) |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2022-02-17 |