| NPI | 1811933690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A93205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 227784) |
| 207Q00000X Family Medicine (Licence: TX L1887) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2021-11-03 |