| NPI | 1285654657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX H9898) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX H9898) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2021-12-02 |