| NPI | 1871582429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: TX N1986) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101228770) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: OK 25914) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX N1986) | |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2014-03-07 |