| NPI | 1093001380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 76204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P9346) |
| 207Q00000X Family Medicine (Licence: IA R9250) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2023-03-07 |