| NPI | 1255338943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR C8442) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K1075) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2007-08-22 |