| NPI | 1881186658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND RL15049) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T3162) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2021-09-23 |