| NPI | 1912102625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P1221) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08784900) |
| 207Q00000X Family Medicine (Licence: NY 258348-1) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2020-06-15 |