| NPI | 1962471508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L2255) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO179838) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2020-09-21 |