| NPI | 1205897006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K7079) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.089315) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2008-01-29 |