| NPI | 1952306482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX S1903) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NM 2001-295) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2022-06-15 |