| NPI | 1821274655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 4831321-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 81057) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2020-05-12 |