| NPI | 1538142930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P5789) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 625OA) |
| 207Q00000X Family Medicine (Licence: CO 43258) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2015-12-04 |