| NPI | 1649420589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX bp10029003) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N5654) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2010-06-11 |