| NPI | 1609118462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2017-01862) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q3587) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2017-10-17 |