| NPI | 1992084768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD222823) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 8390898-1205) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2025-02-21 |