| NPI | 1053514257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q2327) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 56702-21) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2015-03-24 |