| NPI | 1265896641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S4387) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP1-0055778) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2021-02-01 |