| NPI | 1669462677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME79025) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P3753) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2017-05-02 |