| NPI | 1396893491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M6217) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 55090) |
| 207Q00000X Family Medicine (Licence: WA MD00045583) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2014-01-17 |