| NPI | 1548420011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60922847) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N0529) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2021-04-23 |