| NPI | 1013130442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M8165) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2007-00825) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2021-03-15 |