| NPI | 1861437113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 6752592-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 46660) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2014-03-21 |