| NPI | 1164618799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M8715) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A97628) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2016-11-14 |