| NPI | 1902251317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX r5182) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R5182) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2021-09-13 |