| NPI | 1194710178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD432758) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K8951) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2021-09-23 |