| NPI | 1962660969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 8088255-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M-10750) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2022-09-09 |