| NPI | 1114980919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX E5339) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX E5339) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2012-07-30 |