| NPI | 1942412598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS013634) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M6763) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2024-02-09 |