| NPI | 1306829791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L7821) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036098837) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2012-01-25 |