| NPI | 1164787255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9055) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-9508) |
| 207Q00000X Family Medicine (Licence: IA MD-42209) | |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2022-09-15 |