| NPI | 1114985488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q2194) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: TN 38918) |
| 207Q00000X Family Medicine (Licence: AZ 30605) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2016-04-08 |