| NPI | 1477536977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX J8815) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301076998) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2021-06-28 |