| NPI | 1194075101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q5928) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TX Q5928) |
| 207Q00000X Family Medicine (Licence: NY 274855) | |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2015-12-04 |