| NPI | 1013200096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 071158) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10040639) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2022-01-10 |