| NPI | 1760547400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME89284) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX H7277) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2015-12-31 |