| NPI | 1982867008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 8209827-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD29946) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2022-09-06 |