| NPI | 1801881305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 36828) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K0458) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2015-02-05 |