| NPI | 1154434157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX m7065) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 21536) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2012-01-10 |