| NPI | 1750586459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C54217) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C54217) |
| 207R00000X Internal Medicine (Licence: TX J2629) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2020-01-06 |