| NPI | 1952788291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 60684) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T3043) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2022-08-03 |