| NPI | 1437158896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM A-1723-13) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K2574) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2021-04-07 |