| NPI | 1326485848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60946629) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10047433) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2020-12-10 |