| NPI | 1134329782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N0604) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116017080) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2019-03-04 |