| NPI | 1235140153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L9225) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 39862) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2015-04-13 |