| NPI | 1538311162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N1040) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 25933) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2012-11-10 |