| NPI | 1245523695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60479857) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P8001) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX P8001) | |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2021-05-10 |