| NPI | 1295047918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P8061) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 70629) |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2016-04-04 |