| NPI | 1235210048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R5683) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 43875) |
| 207Q00000X Family Medicine (Licence: WA OP60399416) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2018-04-09 |