| NPI | 1194768200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX J8723) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD069841L) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2016-12-21 |