| NPI | 1558450403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 9567115-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301074697) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-11-18 |