| NPI | 1255770624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD18429) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 573605) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2016-12-08 |