| NPI | 1861686917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M7852) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A100246) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2012-06-20 |