| NPI | 1467753798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 10232585-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 8527A) |
| 208D00000X General Practice (Licence: WY 8527A) | |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2022-07-21 |