| NPI | 1538146105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME125308) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 43363) |
| 207Q00000X Family Medicine (Licence: TX N1248) | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2021-11-23 |