| NPI | 1861887119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S7644) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 18073) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2021-02-04 |