| NPI | 1487660726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00031376) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J7456) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2019-09-17 |