| NPI | 1982066528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 66829) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX s4035) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2024-01-03 |