| NPI | 1083720718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A7203) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K6898) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2017-04-18 |