| NPI | 1023078870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX F5194) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX F5194) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2012-02-28 |