| NPI | 1679604524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 38178) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: TX M2784) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2019-07-31 |