| NPI | 1063493963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R0871) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 199935) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2022-04-27 |