| NPI | 1750720306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2020-0294) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R73943) |
| 207Q00000X Family Medicine (Licence: TX Q8154) | |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2020-08-16 |