| NPI | 1518911163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 4199) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L6746) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2017-02-16 |