| NPI | 1801425574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 12439724-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 12439724-8905) |
| Enumeration Date | 2020-04-05 |
| Last Update Date | 2023-09-22 |