| NPI | 1558342360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N7905) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M8672) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2012-01-13 |