| NPI | 1912013749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 42602) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M8096) |
| 207Q00000X Family Medicine (Licence: SC 19512) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2020-03-27 |