| NPI | 1730749003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T7867) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10067497) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2022-08-25 |