| NPI | 1992226229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S6016) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10060856) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2020-08-19 |