| NPI | 1699831586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N3031) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 1839) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2012-06-25 |