| NPI | 1053515619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N4433) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01066481A) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2014-07-07 |