| NPI | 1891204491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T2459) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L.4589R) |
| 207Q00000X Family Medicine (Licence: AL MD.41385) | |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2021-10-20 |