| NPI | 1790210912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: TX S8881) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S8881) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2021-09-09 |