| NPI | 1770891020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R5891) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01072298A) |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2023-03-23 |