| NPI | 1013204932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R1524) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT200451) |
| 207Q00000X Family Medicine (Licence: KY 47498) | |
| 207R00000X Internal Medicine (Licence: TX R1524) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2019-10-17 |