| NPI | 1043449325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P3684) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301095107) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2013-03-21 |