| NPI | 1689745986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P3199) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 102788) |
| 207Q00000X Family Medicine (Licence: MA 233621) | |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2014-05-15 |