| NPI | 1942479894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2009035024) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P3271) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2013-12-02 |