| NPI | 1205034113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 773-4880-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 77348801205) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2023-08-28 |