| NPI | 1881399459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX 1127017) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 901059) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2023-06-28 |