| NPI | 1891135125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S4065) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD191023) |
| 207Q00000X Family Medicine (Licence: LA 303932) | |
| 207Q00000X Family Medicine (Licence: MS 889-L) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2024-10-29 |