| NPI | 1770591935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P7117) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS 9455) |
| 207Q00000X Family Medicine (Licence: PA OS015848) | |
| 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: TX P7117) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2022-10-18 |