| NPI | 1881955193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 72701) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q1869) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2023-02-17 |