| NPI | 1710090048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N3943) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME EC061114) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2009-11-17 |