| NPI | 1912580051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V4508) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 7901) |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2024-10-24 |