| NPI | 1013955996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P1366) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35080283) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2014-08-25 |