| NPI | 1164717922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N9065) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10032442) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2016-02-16 |