| NPI | 1861652372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P5787) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 262613) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2015-11-05 |