| NPI | 1780124040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U4538) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 64876) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2023-10-10 |