| NPI | 1851744189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME160911) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S2600) |
| 208D00000X General Practice (Licence: PR 19251) | |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2023-02-14 |