| NPI | 1801186259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V3023) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 35236) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2024-09-05 |