| NPI | 1780883868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A95172) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 233263) |
| 207Q00000X Family Medicine (Licence: TX Q1599) | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2024-04-11 |