| NPI | 1922653021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX PA14015) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN PA14015) |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2021-12-12 |