| NPI | 1225057854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K0522) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: TX K0522) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2013-04-02 |