| NPI | 1790072676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N9407) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP61017295) |
| 207Q00000X Family Medicine (Licence: FL OS17980) | |
| 207Q00000X Family Medicine (Licence: CA 20A19145) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2024-06-06 |