| NPI | 1275971350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 76949) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10045430) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2020-10-13 |