| NPI | 1932554581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T3709) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK OK6263) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2021-11-07 |