| NPI | 1902250400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S3286) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 65915) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2022-06-28 |