| NPI | 1952491565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2008-01644) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 5333913-1205) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-04-02 |