| NPI | 1689987471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P9470) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301095842) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2015-07-13 |