| NPI | 1811336589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9063) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10046759) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2018-03-17 |