| NPI | 1235171711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME94262) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M3462) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-08-05 |