| NPI | 1295027803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4963) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10039973) |
| Enumeration Date | 2011-05-15 |
| Last Update Date | 2022-01-25 |