| NPI | 1861478125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 10865) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX H2632) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2007-07-08 |