| NPI | 1790118115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 23200) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 29399) |
| 207Q00000X Family Medicine (Licence: TX Q9181) | |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2023-03-03 |