| NPI | 1790896389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S2828) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 243604) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-01-31 |