| NPI | 1184624744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C163169) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 34058) |
| 207Q00000X Family Medicine (Licence: TX K7650) | |
| 207Q00000X Family Medicine (Licence: FL ME88278) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2019-10-08 |