| NPI | 1740262302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G79541) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K5147) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2013-02-25 |