| NPI | 1215228267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9894) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 125707) |
| 207Q00000X Family Medicine (Licence: PR 18161) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2019-12-26 |