| NPI | 1366584021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M9535) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 23955) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2013-01-28 |