| NPI | 1902469018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101272493) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10067053) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2022-07-11 |