| NPI | 1912680331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX 48105) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 48467) |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2024-08-27 |