| NPI | 1790079648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T2867) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 275610) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2022-05-06 |