| NPI | 1801998430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R9397) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A9230) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2019-10-16 |