| NPI | 1578655668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2006-01672) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 118771) |
| 207Q00000X Family Medicine (Licence: TX P8010) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2016-05-05 |