| NPI | 1790128098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9426) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 42727) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2022-09-13 |