| NPI | 1588666226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N4150) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35049646) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2011-12-07 |