| NPI | 1770596041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M3756) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 220369) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2023-07-17 |