| NPI | 1205084555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N8712) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX bp10026636) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2014-08-01 |