| NPI | 1942287065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N1712) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 220361) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2017-03-08 |