| NPI | 1730616749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 73416) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10059860) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2023-02-08 |