| NPI | 1366874745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM CNP-02234) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 338092-8900) |
| 207Q00000X Family Medicine (Licence: UT 338092-4405) | |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2020-09-01 |