| NPI | 1245203835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P1600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 37841) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2012-01-26 |