| NPI | 1487659157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N8050) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS7813) |
| 207Q00000X Family Medicine (Licence: WA OP60046455) | |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2015-02-09 |