| NPI | 1386884286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S0536) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.094372) |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2021-06-04 |