| NPI | 1356342059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9015) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME126089) |
| 207Q00000X Family Medicine (Licence: PR 8730) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2022-03-28 |