| NPI | 1174843221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q1162) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C160571) |
| 207Q00000X Family Medicine (Licence: HI MD-20328) | |
| 207Q00000X Family Medicine (Licence: NM MD2019-0221) | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2019-08-12 |