| NPI | 1558578492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 4631) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX m4012) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2014-03-31 |