| NPI | 1073503959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L7275) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A64474) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2019-04-23 |