| NPI | 1851397822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E8134) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N6987) |
| 207Q00000X Family Medicine (Licence: ID 0-285) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2023-08-14 |