| NPI | 1538272364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 88-64) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J1025) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2008-08-01 |