| NPI | 1700058252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.201399) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N2804) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2011-05-10 |