| NPI | 1043272834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K9108) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ MB070589) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2021-03-22 |