| NPI | 1659391555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX F8220) |
| Additional Taxonomies | 208D00000X General Practice (Licence: ID M-9369) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2014-01-14 |