| NPI | 1912693888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA RN268660) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1126903) |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2023-08-03 |