| NPI | 1184618290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M6828) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35801939 P) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2012-04-11 |