| NPI | 1558432013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX J0281) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 010-54130A) |
| 207Q00000X Family Medicine (Licence: WA MD00049429) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2017-02-24 |