| NPI | 1992863138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C137112) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L2708) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2016-03-07 |