| NPI | 1417375510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Temporary) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 131116) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2018-10-08 |