| NPI | 1972967818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 20130) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R9819) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2020-12-23 |