| NPI | 1265660724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N9171) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2018026857) |
| 207Q00000X Family Medicine (Licence: IL 036144190) | |
| 207Q00000X Family Medicine (Licence: MN 64220) | |
| 207Q00000X Family Medicine (Licence: IA MD-44808) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: TX N9171) | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2019-08-13 |