| NPI | 1275547515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX G2745) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C043271) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2013-01-31 |