| NPI | 1154701142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R3861) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10053768) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2018-07-24 |