| NPI | 1205820305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 34716) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 10438229-1205) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2020-09-23 |