| NPI | 1053631614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q1807) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD14359) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2016-05-09 |