| NPI | 1881892941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.095287) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P3352) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: OH 35095287) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: TX P3352) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2020-11-16 |