| NPI | 1831131127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P2634) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 4078) |
| 207Q00000X Family Medicine (Licence: CA 20A11330) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2015-09-21 |