| NPI | 1801233580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T5127) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015013) |
| 207Q00000X Family Medicine (Licence: PA OS018335) | |
| 207Q00000X Family Medicine (Licence: OH 34.013762) | |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2022-03-22 |