| NPI | 1811272719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A11751) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R4191) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2020-11-04 |