| NPI | 1184829772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N5081) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301095546) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2023-01-06 |