| NPI | 1730275835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 6991A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K7901) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2014-12-31 |