| NPI | 1801080130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 257281) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N9572) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2016-12-19 |