| NPI | 1306139480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P9050) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT199711) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2015-12-15 |