| NPI | 1861062960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U7816) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM RS2021-0653) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2024-03-13 |