| NPI | 1154583136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 27396) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N7879) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2021-04-21 |