| NPI | 1881804540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M7436) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00047482) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2018-05-29 |