| NPI | 1316984560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P9522) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 58629) |
| 207Q00000X Family Medicine (Licence: MD D86547) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA10500600) | |
| 207Q00000X Family Medicine (Licence: PA MD466406) | |
| 207Q00000X Family Medicine (Licence: MA 154211) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2019-09-12 |