| NPI | 1548349814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M5454) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301081371) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2021-07-08 |