| NPI | 1548469299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P9326) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11182) |
| 207Q00000X Family Medicine (Licence: FL ME106704) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2015-06-04 |