| NPI | 1962697755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 27158) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX H8435) |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2023-06-30 |