| NPI | 1386891695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S2102) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 322329) |
| 207Q00000X Family Medicine (Licence: CO 47925) | |
| 207Q00000X Family Medicine (Licence: NV 20997) | |
| 207Q00000X Family Medicine (Licence: KS 04-44574) | |
| 207Q00000X Family Medicine (Licence: AZ 62983) | |
| 207Q00000X Family Medicine (Licence: GA 88895) | |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2021-11-29 |