| NPI | 1497066724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P7036) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301096499) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2013-10-08 |