| NPI | 1396801718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R4040) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 2444410) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2021-10-12 |