| NPI | 1073684783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T0144) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX T0144) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: VA 0101267577) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2022-08-02 |