| NPI | 1205157757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO178919) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P1363) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2018-09-20 |