| NPI | 1972577286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C151203) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K2699) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2020-08-08 |