| NPI | 1922367119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO210569) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10042794) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2023-02-21 |