| NPI | 1265615595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 14741) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N3961) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2014-04-23 |